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Rheumatic irAEs can get on the CAR-T bandwagon, too!
CAR-T can invoke new rheumatological issues (not just cytokine release) - see @DrGomezPuerta's experience.
Infrequent, but if CAR-T in general becomes common, yet another job for us to attend to...
#ACR24 ABST2004 @RheumNow https://t.co/xBSlhUdkNr
David Liew drdavidliew ( View Tweet)
Now that nipocalimab is approved for Sjogren's Disease, what about vaccination response whilst on this FcRn inhibitor (inherently lowers IgG)?
Actually, not bad: takes a little longer to get there, but reassuring!
(always fun to get to know a new med)
#ACR24 ABST1988 @RheumNow https://t.co/IYqIGo5xVP
David Liew drdavidliew ( View Tweet)
Here's a meta-analysis of MACE/malignancy in JAKi vs TNFi in observational cohort studies.
All the epidemiological challenges here aside, it's a good reminder that with ORAL Surveillance it's *cardiovascular risk enriched pts* we're concerned about.
#ACR24 ABST2264 @RheumNow https://t.co/vIXlrI3V2d
David Liew drdavidliew ( View Tweet)
#ACR 2024 BEST Abstracts from Day 2
Here’s a collection of some of the best abstracts presented on day 2 of ACR 2024 as selected by the RheumNow faculty.
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ACR 2024 - Day 2 Report
Plenary sessions began the day, followed by thousands on the abstract floor. Here are a few of my favorite presentations from day 2 at ACR 2024.
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We saw evidence for JAK use in GCA this conference... what about IL-1 inhibition?
Double-blind RCT: Anakinra vs. PBO w/ similar GC taper in GCA pt
NO difference in relapse rate at 26, 52 wks despite addition of Anakinra
@RheumNow #ACR24 Abst1699 https://t.co/gUb0gGJjTG
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Super helpful results from COVER study, holding JAK or IL17 for COVID boosters Antibody titers went up regardless of holding Holding caused flares (14-25% increase!) Pretty clear message; continue JAK / IL17 #ACR24 @RheumNow Abstr#1718 #ACRbest https://t.co/Mf89dWrRWz
Mike Putman EBRheum ( View Tweet)
Would be helpful for us (and pts) to better understand rimmunotherapy agent specific risk on subsequent GCA/PMR
AFTRER propensity matching of >7k pt on combo nivolumab/ipilimumab compared to pembrolizumab:
- PMR RR 3.8x N/I vs. P
- no diff in GCA risk
@RheumNow #ACR24 https://t.co/IF4Gh7Cumd
Brian Jaros, MD Dr_Brian_MD ( View Tweet)
Phase 2 RCT of MK2 inhibitor did not show clinical efficacy at week 12 in active AS pts compared to PBO.
There are still unmet needs for additional therapeutics in pts with AS that not respond to current therapies.
Abst#1760 #ACR24 @RheumNow https://t.co/cXv8HYr0Xr
Adela Castro AdelaCastro222 ( View Tweet)
Comparison of infection risk across b/tsDMARDs in IA in real-world study
Treatment with
➡️Rituximab
➡️JAKi
➡️Anti-IL6
assoc with ⬆️⬆️ risk of severe infection compared to TNFi
A reminder to consider comorbidities & infection risk in selecting b/tsDMARDs
Ab1716 #ACR24 @RheumNow
Mrinalini Dey DrMiniDey ( View Tweet)
RCTs are the gold standard in drug research, but rising placebo (PBO) response rates with global recruitment could distort treatment effects. Limited access to care in less affluent countries may be a factor.
#ACR24 @RheumNow ABST#1746 https://t.co/fVeNcw5qwO
Jiha Lee JihaRheum ( View Tweet)
In this systematic review & metaanalyis by Dr. RFarhat et al, tacrolimus whole blood levels decrease in the 1st & 2nd trimesters then increase back to pre-pregnancy levels postpartum.
Needs further studies to guide dose adjustment.
@RheumNow #ACR24 abs1535 https://t.co/5MovzPJoFc
sheila RHEUMarampa ( View Tweet)
Dr. BDinneen et al reported predictors that can help screen axSpA pts w/o traditional CV RFs for carotid doppler utz:
- shorter dse duration
- no family hx of IHD
- HLAB27+
- ⬆️ dBP, WHratio, ferritin, TC, LDL and TC:HDL ratio
Small size, more data reqd
@RheumNow #ACR24 abs1440 https://t.co/3pZxFmutJz
sheila RHEUMarampa ( View Tweet)
Ab1676 discussed an intervention to change patient mindsets about side-effects of #methotrexate. Watch my video for @RheumNow on this abstract here:
https://t.co/NxuxQ5wYda
#ACR24
Mrinalini Dey DrMiniDey ( View Tweet)
Wu et al. MDA5-DM. Propensity-score cohort study. 672 patients. Tofacitinib vs CNI. Primary outcome 1 year death or lung transplant. HR 0.70 favouring tofacitinib. @RheumNow #ACR24 Abstr#1736 https://t.co/A0aHhp1q9c https://t.co/LbutJDBllr
Richard Conway RichardPAConway ( View Tweet)
Wu et al. MDA5-DM. Propensity-score cohort study. 672 patients. Tofacitinib vs CNI. Primary outcome 1 year death or lung transplant. HR 0.70 favouring tofacitinib. @RheumNow #ACR24 Abstr#1736 https://t.co/A0aHhp1q9c https://t.co/LbutJDBllr
Richard Conway RichardPAConway ( View Tweet)
A#1747
RA mortality by race/ethnicity
Database study
>200,000 pts had RA as contributing cause of death
5.1 ASMR in American Indian >>> all other groups
No decr over time in grp, unlike other grps
Odds of death 1.67 compared to white pop
10.8x higher in pts <44
#ACR24 @RheumNow https://t.co/nXLcQkQPu4
Eric Dein ericdeinmd ( View Tweet)
Chinoy et al. Baricitinib in IIM. Delayed-start clinical trial. 15 patients. 14/15 improved at 24 weeks (the other withdrew). 50% vs 100% at week 12 (delayed start group initiation). Stats confuse me a bit here but promising. @RheumNow #ACR24 Abstr#1731 https://t.co/orewsxbPpL https://t.co/5AyRpYJdec
Richard Conway RichardPAConway ( View Tweet)
Chinoy et al. Baricitinib in IIM. Delayed-start clinical trial. 15 patients. 14/15 improved at 24 weeks (the other withdrew). 50% vs 100% at week 12 (delayed start group initiation). Stats confuse me a bit here but promising. @RheumNow #ACR24 Abstr#1731 https://t.co/orewsxbPpL https://t.co/5AyRpYJdec
Richard Conway RichardPAConway ( View Tweet)
RA patients on TOF with h/o ASCVD have 4x higher risk of MACE without statin (vs. TNFi).
Prioritize statins for heart health in RA!
#ACR24 @RheumNow ABST#1745 https://t.co/jRqXNU2T6d
Jiha Lee JihaRheum ( View Tweet)